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The first line of treatment is the removal of the source of inflammation or infection by local operative measures. [9] Generally, the abscess can be eradicated through surgical drainage alone; however this is sometimes inadequate. Therefore, systemic antibiotic treatment may be required, but only if there is evidence of spreading infection. [9]
In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth. This can be caused by tooth decay, broken teeth or extensive periodontal disease (or combinations of these factors). A failed root canal treatment may also create a similar abscess.
A periodontal abscess occurs alongside a tooth, and is different from the more common [2] periapical abscess, which represents the spread of infection from a dead tooth (i.e. which has undergone pulpal necrosis). To reflect this, sometimes the term "lateral (periodontal) abscess" is used.
Although mouth infections can present in many different ways, they are managed according to the same guiding principles - protect the airway, drain the abscess, and treat with antibiotics if necessary. Securing a patient's airway is the most important part of initial treatment because loss of airway is emergently life-threatening.
"Cavities, gum disease and tooth abscess are the most common causes of pain in the mouth developed by bacteria," says Arlene A. Asante, a dentist at First Class Smiles of Bethesda. Cavities can ...
Odontogenic infections can be severe if not treated and are associated with mortality rate of 10 to 40%. [4] Furthermore, about 70% of odontogenic infections occur as periapical inflammation, i.e. acute periapical periodontitis or a periapical abscess. [3] The next most common form of odontogenic infection is the periodontal abscess. [3]
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